A common side effect associated with Zoloft (sertraline) is sleepiness and insomnia. It is thought that the change in the level of serotonin, a chemical that regulates your sleep in your body, is one of the reasons why people often experience this side effect. Sleepiness tends to go away after a week or two and there are tips on how to manage these symptoms.
What Is Zoloft (Sertraline) & What Is it Used to Treat?
Zoloft (sertraline) is an antidepressant that belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). It works by blocking the reabsorption of the chemical serotonin by nerves, leaving more of it available for the body to use. It is thought that with more serotonin available, it could help with the imbalance of chemicals seen in people with certain disorders. 1, 2, 3
Zoloft is approved by the FDA for the use of major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder (PD), posttraumatic stress disorder (PTSD), social anxiety disorder (SAD), and premenstrual dysphoric disorder (PMDD). 1, 2
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Does It Make You Tired?
Changes in sleep habits are common side effects of Zoloft, and can cause increased sleepiness or insomnia. Zoloft may also cause manic episodes, a side effect for people who have bipolar disorder, where symptoms may include greatly increased energy and severe trouble sleeping.1, 2, 3
These changes can result in a person feeling tired or fatigued. Side effects typically are mild at the start of treatment, but generally improve with time. These often improve over the first week or two of therapy.4, 5 If symptoms persist or worsen, speak with your physician about what changes can be made to your therapy.
Why Does Zoloft Make You Sleepy?
The exact reason why Zoloft causes sleepiness isn’t known, but there are theories. One reason could be that Zoloft works by increasing the level of serotonin which is a chemical involved with mood regulation as well as sleep regulation. With the change in serotonin levels, it may impact the sleep-wake cycle and lead to drowsiness or sedation in some individuals.
Another consideration would be the individual factors of the person taking Zoloft. Each person’s experience with side effects is different given that each person has differing genetic and physical characteristics. Lastly, the dosage and timing of Zoloft can be a reason why some become lethargic on this medication. Higher doses are more likely to cause drowsiness. If Zoloft makes you drowsy, then taking it in the morning can make the side effect noticeable.1, 2, 3
Disclaimer: All medications, including Zoloft, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
Can Other Antidepressants Cause Fatigue?
All antidepressant groups can cause fatigue. Medication classes like tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs) change the amount of chemicals available for our body to use, meaning that there are similar side effects.6
Whether you experience fatigue on a certain medication or not depends on personal characteristics, such as genetics, weight, and sex. If you experience fatigue on these medications, discuss with your doctor if it is persistent or bothersome. Do not discontinue any therapy by yourself.
Activities to Avoid When You Are Fatigued
While fatigued, one should be careful with the activities they partake in. They could present safety risks not only for yourself, but for those around you. If you feel that you are tired or fatigued, then you should not drive, operate heavy machinery, or do other dangerous activities. You should also avoid drinking alcohol while on Zoloft because they can interact and make side effects worse, including fatigue and dizziness.1, 2, 3
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Strategies to Reduce Tiredness
Tiredness may be frustrating. It can lead to decreased productivity and make even normal tasks feel like challenges. It could also impact your life dangerously by making you less aware, increasing your risk of injury for activities like driving. Zoloft’s side effect of tiredness can make a significant impact on someone’s life, but there are ways to cope with this side effect.
Follow Good Sleep Hygiene
There are strategies that can be followed to increase the likelihood of obtaining quality rest. Sleep hygiene helps you to build the habits to obtain better sleep, and coupled with setting up your environment to aid these habits, you may be able to reduce tiredness.
Some sleep helpful hygiene habits include:7
- Go to bed and wake up at the same time each day
- Avoid daytime napping if possible
- Avoid caffeine, nicotine, and alcohol before bedtime
- Manage stress
- Remove electronic devices, such as smartphones, computers, TVs, from the bedroom
When to Seek Professional Help
People on medications like Zoloft will typically see side effects when they first start taking the medication. These side effects, including fatigue and sleep issues, often get better after a week or two of continued therapy. If you are experiencing side effects and they persist beyond a few weeks or worsen, then you need to see your prescriber to discuss your usage of Zoloft.
It is dangerous to change the way you are taking Zoloft without medical supervision. Some options your doctor may consider would be reducing the dosage or switching antidepressants in order to find a therapy that is both effective and safe. If you are in need of a new or more accessible psychiatrist, online psychiatry options are available.
Antidepressant Discontinuation Syndrome
Zoloft should never be reduced in dosage or stopped by yourself, even if side effects are uncomfortable. Doing so can result in a reaction called Discontinuation Syndrome, also known as antidepressant withdrawal, which occurs after abruptly stopping Zoloft and similar antidepressants. Within a day or two, you can see side effects such as nausea, tremor, insomnia, confusion, anxiety, irritability, seizures, and electric shock sensations.1, 2 If you are thinking of stopping Zoloft, consult a doctor.
Questions to Ask Your Healthcare Provider About Feeling Tired While Taking Zoloft
Fatigue and tiredness is a common side effect of Zoloft. One should keep in mind that as a person’s body adjusts to the medication, they might experience side effects, but it should be temporary. Before and during your treatment with Zoloft, you should ask questions of your doctor, psychiatrist, and therapist so you know what to expect. Online psychiatry services may be a good source of help if you are unable to visit a healthcare provider in person.
Questions to ask your care team about feeling tired while taking Zoloft:
- How long will it take for me to adjust to taking Zoloft?
- Am I at risk for more fatigue and sleepiness if I am already taking other anxiety /depression medications?
- What is the best dosage to prevent or reduce fatigue?
- When should I reach out to you if I am experiencing fatigue?
- Is there anything I should tell my therapist about this new medication?
- Are there any other factors that might be contributing to my sleepiness?
- Can taking zoloft at a different time of day minimize the effect on my energy levels?
- Are there any alternative medications that may have fewer fatigue-related side effects than Zoloft?
In My Experience
In my experience, side effects of Zoloft are often tolerable and do go away within the first week or two of starting the medication. Tiredness and sleep issues are challenging and common side effects, but they can be managed with proper techniques such as sleep hygiene. Most that start this medication tolerate it, but if you find yourself unable to tolerate Zoloft’s side effects, then you should discuss this with your prescriber.
It is important not to change or stop your therapy by yourself because it can cause withdrawal effects. Patients should also be aware of the fact that Zoloft, along with most depression medications, can take up to 6 to 8 weeks to see full benefits.
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